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TITLE 16 HEALTH AND SAFETY DELAWARE ADMINISTRATIVE CODE 3 The family will receive Transitional Group coverage without any reapplication for the first six months. To continue to receive Transitional Group coverage throughout the first six-month period there must be a dependent child living in the home. Eligibility will be terminated if the family is found to have received Medicaid fraudulently in the preceding six months. A conviction for fraud must be made by a court of competent jurisdiction. 15110.8 Transitional Group Eligibility during Second Six-Month Period To continue to receive Medicaid during the second six-month period, the following eligibility conditions described in Section 15110.8.1, Section 15110.8.2, and Section 15110.8.3 must be met. 15110.8.1 Child Living in the Home There must be a dependent child living in the home. 15110.8.2 Employment of Caretaker Relative The parent or caretaker relative must be employed during each month unless good cause exists. Good cause includes the following: a. Circumstances beyond the individual's control such as but not limited to illness, illness of another family member requiring the wage earner’s presence, a household emergency, the unavailability of transportation, and the lack of adequate dependent care. b. Circumstances in which employment was unsuitable such as wages offered less than the Federal minimum wage; employment on a piece-rate basis and the average hourly yield the employee receives is less than the Federal minimum wage; unreasonable degree of risk to one's health and safety; the individual is physically or mentally unfit to perform the employment as documented by medical evidence or reliable information from other sources; the distance from the individual's house to place of employment is unreasonable considering the expected wage and the time and cost of commuting; or the working hours or nature of employment interferes with the members religious observance, convictions or beliefs. c. Discrimination by an employer based on age, race, sexual orientation or gender identity, disability, religious belief, national origin, or political belief. d. Work demands or conditions that are unreasonable such as working without being paid on schedule. e. Acceptance of other employment or enrollment at least half-time in a school, training program, or college. f. Resignations by persons under the age of 60 that are recognized by the employer as retirement. g. Leaving a job in connection with patterns of employment in which workers move from one employer to another as in migrant farm labor or in construction work. 15110.8.3 Limit on Gross Monthly Earned Income The family's gross monthly earned income minus the monthly costs of necessary dependent care must not exceed 185% of the federal poverty level (FPL). The FPL is effective each July for the Transitional Group. There are no limits on necessary dependent care costs. All unearned income and the earned income of a dependent child is excluded. 15110.9 Twelve-Month Period of Transitional Group Eligibility A family may receive twelve months of Transitional Group coverage even if eligibility is re-established under the Parent/ Caretaker Relative Group. The clock on the twelve-month period does not stop running when eligibility for Medicaid under this group is re-established. The twelve months of Transitional Group eligibility run concurrently with months of eligibility under the Parent/Caretaker Relative Group. If eligibility is lost under the Parent/Caretaker Relative Group for non-work reasons, the Transitional Group extension period is unaffected. If eligibility is lost again under the Parent/Caretaker Group for earned income, a new Transitional Group period may begin. 15110.10 Four-Month Period of Transitional Group Eligibility This section applies if the twelve-month extension period described above is not re-authorized. A family may receive up to four months of Transitional Group coverage provided the requirements described in Section 15110.2, Section 15110.3, and Section 15110.4 are met. There is no income test throughout the four-month period. 15120 Prospective Group This section describes the eligibility requirements under the Prospective Group. Prospective Group is an extended eligibility period of up to four consecutive calendar months for a family who becomes ineligible due to an increased collection of spousal support.